Unusual presentations of cutaneous leishmaniasis: pearls for correct diagnosis

Fatemeh Mohaghegh ◽  
Parvaneh Hatami ◽  
Mina Saber ◽  
Asieh Heidari ◽  
Azadeh Zolfaghari ◽  
2020 ◽  
Vol 28 (4) ◽  
pp. 348-351
Zufishan Batool ◽  
Shifa Basharat ◽  
Maria Khan ◽  
Nosheen Ali ◽  
Maria Tasneem Khattak ◽  

Objective: To evaluate the hematological and clinical features of Visceral and Cutaneous Leishmaniasis. Materials and Methods: This was hospital-based retrospective study which included all cases of Cutaneous leishmaniasis and Visceral leishmaniasis that were diagnosed from Jan 2018 till December 2019 at Pathology Department, Rehman Medical Institute, Peshawar. The diagnosed cases were analyzed for clinical and laboratory profile in details, results of CBC, demographic information and physical signs at presentation were noted as well as bone marrow aspirations were performed for LD bodies. Results: Out of 104 cases, 36 (34.61%) visceral leishmaniasis and 68 (65.38%) cutaneous leishmaniasis were observed during the study period, in which 82 (78.85%) were male and 22 (21.15%) were females. Age range was from 03-40 years with mean of 23 + 4.21 years. Intermittent fever was observed in almost all the cases of visceral leishmaniasis and 52 (76.47%) of cutaneous leishmaniasis. All patients with visceral leishmaniasis had hepatomegaly and splenomegaly. Patients with CL presented as lesions on face and foot region.  In VL all patients were male, while in CL 46 were males and only 22 were females. Majority (83.33%) of patients in VL were children (age group 1-10 years), in cutaneous leishmaniasis 34 (50%) were in age group 31-40 years. Conclusion: Our study concludes that leishmaniasis mainly affecting age group 10-20 years. Patients with visceral Leishmaniasis presented with pallor, weight loss fever and splenomegaly while those with cutaneous leishmaniasis presented with lesions on the foot and face especially nose. Anemia and thrombocytopenia were most common hematological parameters. It is essential that the Public Health authorities be more aware of the condition in order to improve environmental sanitation and personal protective measures and to establish diagnostic laboratories for early and correct diagnosis and treatment.  

2018 ◽  
Vol 146 (10) ◽  
pp. 1267-1274 ◽  
S. K. Söbirk ◽  
M. Inghammar ◽  
M. Collin ◽  
L. Davidsson

AbstractIn Sweden, leishmaniasis is an imported disease and its epidemiology and incidence were not known until now. We conducted a retrospective, nationwide, epidemiological study from 1993 to 2016. Probable cases were patients with leishmaniasis diagnoses reported to the Swedish Patient registry, collecting data on admitted patients in Swedish healthcare since 1993 and out-patient visits since 2001. Confirmed cases were those with a laboratory test positive for leishmaniasis during 1993–2016. 299 probable cases and 182 confirmed cases were identified. Annual incidence ranged from 0.023 to 0.35 per 100 000 with a rapid increase in the last 4 years. Of 182 laboratory-verified cases, 96 were diagnosed from 2013 to 2016, and in this group, almost half of the patients were children under 18 years. Patients presented in different healthcare settings in all regions of Sweden. Cutaneous leishmaniasis was the most common clinical manifestation and the majority of infections were acquired in Asia including the Middle East, specifically Syria and Afghanistan. Leishmania tropica was responsible for the majority of cases (42%). A combination of laboratory methods increased the sensitivity of diagnosis among confirmed cases. In 2016, one-tenth of the Swedish population were born in Leishmania-endemic countries and many Swedes travel to these countries for work or vacation. Swedish residents who have spent time in Leishmania-endemic areas, could be at risk of developing disease some time during their lives. Increased awareness and knowledge are needed for correct diagnosis and management of leishmaniasis in Sweden.

2020 ◽  
Vol 5 (2) ◽  
pp. 439-456
Jenny L. Pierce

Purpose This review article provides an overview of autoimmune diseases and their effects on voice and laryngeal function. Method A literature review was conducted in PubMed. Combinations of the following keywords were used: “autoimmune disease and upper airway,” “larynx,” “cough,” “voice,” “dysphonia,” and “dyspnea.” Precedence was given to articles published in the past 10 years due to recent advances in this area and to review articles. Ultimately, 115 articles were included for review. Results Approximately 81 autoimmune diseases exist, with 18 of those highlighted in the literature as having laryngeal involvement. The general and laryngeal manifestations of these 18 are discussed in detail, in addition to the clinical implications for a laryngeal expert. Conclusions Voice, breathing, and cough symptoms may be an indication of underlying autoimmune disease. However, these symptoms are often similar to those in the general population. Appropriate differential diagnosis and timely referral practices maximize patient outcomes. Guidelines are provided to facilitate correct diagnosis when an autoimmune disease is suspected.

1971 ◽  
Vol 25 (03) ◽  
pp. 438-446 ◽  
E. J Melliger ◽  
F Duckert

SummaryA further case of parahaemophilia is reported. One year after the correct diagnosis had been made the patient had to undergo cholecystectomy which was performed under prophylactic substitutive treatment with fresh plasma at a factor V level of 31 %. A minimal factor V level of 11 to 12% was maintained throughout the first week after operation. There was no abnormal postoperative bleeding. The half disappearance time of factor V was found to be about 12 h. Infusion of equivalent amounts of fresh plasma supplied a higher yield of factor V in the patient’s plasma before operation than postoperatively what may be explained by an increased diffusion of factor V into the intercellular space resulting from a postoperatively increased capillar permeability. The results are compared with those of other authors.

2019 ◽  
M Razpotnik ◽  
S Bota ◽  
G Essler ◽  
J Weber-Eibel ◽  
M Peck-Radosavljevic

2016 ◽  
Vol 12 (1) ◽  
pp. 13-24 ◽  
Katie Ekberg ◽  
Markus Reuber

There are many areas in medicine in which the diagnosis poses significant difficulties and depends essentially on the clinician’s ability to take and interpret the patient’s history. The differential diagnosis of transient loss of consciousness (TLOC) is one such example, in particular the distinction between epilepsy and ‘psychogenic’ non-epileptic seizures (NES) is often difficult. A correct diagnosis is crucial because it determines the choice of treatment. Diagnosis is typically reliant on patients’ (and witnesses’) descriptions; however, conventional methods of history-taking focusing on the factual content of these descriptions are associated with relatively high rates of diagnostic errors. The use of linguistic methods (particularly conversation analysis) in research settings has demonstrated that these approaches can provide hints likely to be useful in the differentiation of epileptic and non-epileptic seizures. This paper explores to what extent (and under which conditions) the findings of these previous studies could be transposed from a research into a routine clinical setting.

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